Joseph DP, Ryan EH, Ryan CM, et al. Primary Retinal Detachment Outcomes Study: Pseudophakic Retinal Detachment Outcomes. Ophthalmology 2020. Online ahead of print.
This study is part 3 of the PRO (Primary Retinal Detachment Outcomes) Study. Part 3 specifically looks at outcomes of pseudophakic retinal detachments treated with pars plana vitrectomy (PPV) or PPV with scleral buckle (PPV-SB). This was part of a multicenter, retrospective, interventional cohort study, with the primary endpoint being single-surgery anatomic success (SSAS), defined as retinal attachment without ongoing tamponade and without additional retinal detachment surgery within 90 days.
There were 1158 of 2620 eyes (44%) that had pseudophakic primary retinal detachments. A total of 1018 eyes had greater than 90 days of follow-up. PPV was performed in 684 eyes (77%) and PPV-SB was performed in 209 eyes (23%). Overall SSAS was achieved in 84% of the PPV group (577/684) and 92% of the PPV-SB group (193/209), which was statistically significant (p=0.009). In eyes with macula-on retinal detachments, SSAS was 88% (238/270) in the PPV group and 100% (52/52) in the PPV-SB group (p=0.0088). In eyes with macula-off retinal detachments, SSAS was 81% (278/344) in the PPV group and 89% (116/130) in the PPV-SB group (p=0.029). Final visual acuity was not different between PPV and PPV-SB for macula-on and macula-off subgroups.
The take-away point from this paper is that single-surgery anatomic success was better in pseudophakic patients treated with PPV-SB compared to those in whom PPV alone was performed.
Priya Sharma Vakharia, MD
The Retina Group of Washington
Annapolis & Greenbelt, MD